Evaluación in vitro de la filtración apical de dos cementos y dos procedimientos de obturación con y sin la adición de un adhesivo dentinario / In vitro apical leakage evaluation of two sealers and two obturation techniques both with and without dentin adhesive

El objetivo de este trabajo fue analizar la filtración apical de dos cementos y dos procedimientos de obturación con y sin la adición de un adhesivo dentinario. Para ello se usaron 80 raíces de dientes monoradiculares que fueron instrumentadas mediante el sistema HERO. De las 80 raíces que fueron instrumentadas se formaron 8 grupos, seis de estos fueron grupos experimentales, mientras que los dos restantes se usaron como grupos control. En el grupo 1 se incluyeron 10 raíces que fueron obturadas con cemento EndoREZ y punta única, el grupo 2 fue obturado con EndoREZ, punta única y la adición de un adhesivo, el grupo 3 con cemento EndoREZ y condensación lateral, el grupo 4 con EndoREZ, condensación lateral y adhesivo, el grupo 5 con cemento AH Plus y condensación lateral y el grupo 6 con AH Plus, condensación lateral y adhesivo. En el grupo 7 (control positivo) se incluyeron 10 raíces que fueron instrumentadas pero que no se obturaron. En el grupo 8 (control negativo) se incluyeron 10 raíces las cuales fueron totalmente cubiertas por dos capas de laca de uñas. Todos los dientes fueron sumergidos en azul de metileno durante 48 h, después de lo cual todos los especimenes fueron limpiados con agua y almacenados en medio húmero a 37°C. La evaluación se realizó mediante transparencia de los dientes los cuales fueron examinados mediante un estéreomicroscopio a 60 aumentos. No se hallaron diferencias en cuanto a la filtración. El uso de un adhesivo dentinario tampoco mejoró el sellado del ápice

The aim of the study was to compare the apical microleakage of two kins of cement and two differentobturation procedures, with and without dentin bonding agent. We used 80 monoradicular roots treated instrumentally with the HERO system. Roots were divided in eight groups, six of them experimental, and two controls. Each group included 10 cases each. In group 1 roots were obtured with EndoREZ cement and single point, group 2 was treated as group 1, plus dentin bonding agent. Group 3 was obtured with EndoREZ cement and lateral condensation, group 4 followed same treatment as group 3 but adding dentin bonding agent. Groups 5 and 6 used AH plus cement and lateral condensation, with the later including dentin bonding agent. In our positive control group (group 7) roots were instrumented but not obtured. Instead in the negative control group (group 8) roots were covered by two layers of nails varnish only. All teeth were dipped in metilen blue for 48 hours, washed with water and stored afterwards at 37°C. Cases were evaluated for teeth transparency with a stereomicroscope x60. There was no difference regarding microleakage and the use of an adhesive didn't improve the apex seal

[Epidermoid cyst of the testicle: presentation of a case]. / Quiste epidermoide del testículo: presentación de un caso.

OBJECTIVE: To describe a case of epidermoid cyst of the testis, a rare lesion that warrants surgical exploration to confirm the diagnosis since its echo patterns are characteristic but not pathognomonic. METHODS/RESULTS: 10 years earlier the patient had noticed an asymptomatic swelling of the right testis which did not cause infertility since he had two children over the last 6 years. Tumor markers AFP, BHCG and LDH fell within the normal ranges. Ultrasound evaluation with a high resolution 7.5 Mhz transducer revealed a 4 x 3.5 x 3.2 cm testicular mass surrounded by atrophic parenchyma. The patient underwent radical inguinal orchidectomy. CONCLUSIONS: Epidermoid cyst is the benign variety of testicular teratoma. Two different forms exist: simple and mixed. Malignant components are present in the latter form. If the simple form is identified before substitution of the testicular parenchyma occurs, testis sparing surgery is justified; otherwise radical orchidectomy with inguinal exploration is indicated.

[Replacement bladders in Oltrepo]. / Le vesciche di sostituzione in Oltrepo.

In our Department we performed 269 radical cystectomies from January 1985 to April 1996. As regard the urinary diversion 64 patients were undergone to a cutaneous ureterostomy; in 137 we performed a Wallace uretero-intestinal anastomosis; in 6 a Mauclaire rectal diversion; in 12 patients a Mainz Pouch II and 50 selected patients (44 man and 6 ladies) we performed a Vesica Ileale Padovana (VIP). In these cases the stage was lowly, good renal function, no are hydronephrosis. The patients were motivated for a long follow-up and preoperatively undergone to urethral biopsies. We have had the following complications: an early bowel obstruction, 4 wound infections and for the long term follow-up 2 inguinal hernias, 1 laparocele, 5 patients with bilateral hydronephrosis. At the moment we cannot state a correct oncological report for the short follow-up: only 1 patient died after 18 months for a pelvic relapse. We can suggest that VIP is a good solution for the ladies: its mandatory to take care of the urethra and the pelvic floor for a good continence limiting the lymphadenectomy. We haven't any suggestions about the deep of the colpectomy and the opportunity of the vaginal suspension.

[pT1G3 tumor of the bladder]. / Il tumore della vescica pT1 G3.

The management of the superficial bladder tumor is commonly performed by transurethral resection (TUR) and a following chemotherapy or immunotherapy with exception of Tis. A lot of doubts and questions raise in the management of pT1G3 bladder tumor (BT) for the high grade of recurrencies and progressions. Our experience from 1984 to 1994 about 109 patients (pts) with pT1G3 BT undergone to radical cystectomy (47 pts) and TUR (62 pts) allows us to state that when Tis is present a radical cystectomy is mandatory, but the TUR option must be followed to frequent and accurate random biopsies in order to discovery foci of Tis. In the case of pT1G3 monofocal there is always a therapeutic disconcerting.

[Incision of the bladder neck]. / L'incisione del collo vescicale.

Transurethral incision of the bladder neck (TUIBN) is a simple method of relieving bladder outflow obstruction producing similar results to transurethral resection of the prostate (TURP) when obstruction is caused by small prostate (< 40 gr). The complication rate is low and retrograde ejaculation has a far less degree than after TURP, so less bleeding. The major advantage of TUIBN are: short hospitalization, less bladder neck contractures. The drawback of the absence of prostate tissue for an earlier diagnosis of cancer can be balanced performing a biopsy before treatment.

[Intraurethral devices in the treatment of prostatic obstruction]. / I dispositivi intrauretrali nella terapia dell'ostruzione prostatica.

We describe our experience (started in 1988) about the use of urethral stents implanted into patients with prostatic outflow obstruction, unit for prostatic surgery. This technique has been applied successfully with few complications. The use of different stents (Fabian's spiral, mesh stent) allowed us to get the right choices in the different shapes of prostatic urethra and in the different expectancies of the patients. Lastly we can offer an useful recommendation about the patients evaluation and the stents selection.